The purpose of this initiative is to strengthen and sustain, through collaborative research and training, the capability of Pakistani scientists to contribute to maternal and child health research efforts by addressing factors appropriate to Pakistan which contribute to poor pregnancy outcomes and the poor health status of mothers and children in Pakistan. This training program is intended to be multidisciplinary and to include both biomedical, sociocultural and behavioral research issues. This application is being submitted concurrently with a response for the establishment in Pakistan of a Maternal and Child Health Research Center between the University of Alabama at Birmingham (UAB) and the Aga Khan University (AKU) in Karachi, Pakistan, as part of a Global Network for Women?s and Children?s Health Research Program (RFA HD-QO-007). The training and research capacity building efforts of our Fogarty International Center (FIC) International Maternal and Child Health Research and Training Program (IMCHRT) are meant to facilitate maternal and child health research to improve pregnancy and birth outcomes in Pakistan such as will be undertaken by the UAB-AKU Maternal and Child Health Research submitted under the Global Network program. This program will build efficiently from the highly successful UAB-Pakistan relationship of the UAB Fogarty AIDS International Training and Research Program. We expect to strengthen the establishment of a Maternal and Child Research Center at the Aga Khan University in Karachi by providing critical expertise in biomedical, behavioral and prevention research in maternal and child health to Pakistani scientists and research support staff. Training will be offered both in the U.S. at UAB and at AKU and will include degree-seeking training in Public Health, short- term training, and a web-based distance-learning program between UAB and AKU. This training program will promote the initiation of new maternal and child health research within the UAB-AKU Global Network Research Center (if awarded) and facilitate the establishment of long-term collaborative relationships between U.S. investigators and Pakistani trainees. We are confident that our emphasis on developing AKU?s independent capacity to provide regional leadership in training and research is the best long-term investment of Fogarty and NICHD resources.